"Of, relating to, or designating a person whose identity does not conform unambiguously to conventional notions of male or female gender roles, but combines or moves between these."

"People who were assigned a sex, usually at birth and based on their genitals, but who feel that this is a false or incomplete description of themselves."

"Non-identification with, or non-presentation as, the sex (and assumed gender) one was assigned at birth.

A transgender individual may have characteristics that are normally associated with a particular gender, identify elsewhere on the traditional gender continuum, or exist outside of it as "other," "agender," "intergender," or "third gender". Transgender people may also identify as bigender, or along several places on either the traditional transgender continuum, or the more encompassing continuums which have been developed in response to the significantly more detailed studies done in recent years.

Evolution of the term transgender

The term transgender (TG) was popularised in the 1970s (but implied in the 1960s) describing people who wanted to live cross-gender without sex reassignment surgery. In the 1980s the term was expanded to an umbrella term and became popular as a means of uniting all those whose gender identity did not mesh with their gender assigned at birth. In the 1990s the term took on a political dimension as an alliance covering all who have at some point not conformed to gender norms, and the term became used to question the validity of those norms or pursue equal rights and anti-discrimination legislation, leading to its widespread usage in the media, academic world and law. The term continues to evolve.

Transgender identities

While people identify as transgender, transgender identity includes many overlapping categories. These include cross-dresser (CD); transvestite (TV); androgynes; genderqueer; people who live cross-gender; drag kings; and drag queens; and, frequently, transsexual (TS). Usually not included because it is considered to be a paraphilia (rather than gender identification) are transvestic fetishists. In an interview, artist RuPaul talked about society's ambivalence to the differences in the people who embody these terms. "A friend of mine recently did the Oprah show about transgender youth," said RuPaul. "It was obvious that we, as a culture, have a hard time trying to understand the difference between a drag queen, transsexual, and a transgender, yet we find it very easy to know the difference between the American baseball league and the National baseball league, when they are both so similar." These terms are explained below.

The extent to which intersex people (those with ambiguous genitalia or other physical sexual characteristics) are transgender is debated, since not all intersex people disagree with their gender assigned at birth. The current definitions of transgender include all transsexual people, although this has been criticized. (See below.)

The term transman refers to female-to-male (FtM or F2M) transgender people, and transwoman refers to male-to-female (MtF or M2F) transgender people, although some transgender people identify only slightly with the gender not assigned at birth. In the past, it was assumed that there were far more transwomen than transmen, but a Swedish study estimated a ratio of 1.4:1 in favour of transwomen for those requesting sex reassignment surgery and a ratio of 1:1 for those who proceeded. There is a school of thought that says terms such as "FtM" and "MtF" are subjugating language that reinforces the binary gender stereotype.

The term cisgender has been coined as an antonym referring to non-transgender people; i.e. those who identify with their gender assigned at birth.

Transsexual

Transsexual people identify as, or desire to live and be accepted as, a member of the sex opposite to that assigned at birth.

Many transsexual people have a wish to alter their bodies. These physical changes are collectively known as sex reassignment therapy and often include hormone replacement therapy and sex reassignment surgery. References to "pre-operative", "post-operative" and "non-operative" transsexual people indicate whether they have had, or are planning to have sex reassignment surgery. People who have transitioned, who do not necessarily identify as transgender or transsexual any longer; they identify as simply a man or a woman. Those that continue identifying as transsexual don't want to ignore their pre-transition life and may continue strong ties with other trans people and raising social consciousness.

Cross-dresser

The term 'cross-dresser' is not exactly defined in the relevant literature. Michael A. Gilbert, professor at the Department of Philosophy, York University, Toronto, offers this definition: "[A cross-dresser] is a person who has an apparent gender identification with one sex, and who has and certainly has been birth-designated as belonging to one sex, but who wears the clothing of the opposite sex because it is the clothing of the opposite sex." This excludes people "who wear opposite sex clothing for other reasons". Also, the group doesn't include "those female impersonators who look upon dressing as solely connected to their livelihood, actors undertaking roles, individual males and females enjoying a masquerade, and so on. These individuals are cross dressing but are not cross dressers."
Cross-dressers may not identify with, or want to be the opposite gender, nor adopt the behaviors or practices of the opposite gender, and generally do not want to change their bodies medically. The majority of cross-dressers identify as heterosexual.

Transvestite

A transvestite is somebody who cross-dresses. The term "transvestite" is used as a synonym for the term "cross-dresser", although it has been stated that "cross-dresser" is the preferred term. The term "transvestite" and the associated term "transvestism" are conceptually different from the term "fetishistic transvestism" (a.k.a. "transvestic fetishism"), as "transvestic fetishist" describes those who intermittently use clothing of the opposite gender for fetishistic purposes, and "transvestite" does not. In medical terms, transvestic fetishism is differentiated from cross-dressing by use of the separate codes 302.3 in the DSM and F65.1 in the ICD.

Drag kings and queens

Drag is a term applied to clothing and make-up worn on special occasions for performing or entertaining as a hostess, stage artist or at an event (e.g. Lypsinka). This is in contrast to those who cross-dress for other reasons or are otherwise transgender. Drag can be theatrical, comedic, or grotesque, and female-identified drag has been considered a caricature of women by second-wave feminism. Within the genre of drag are gender illusionists who do try to pass as another gender. Drag artists explore gender issues and have a long tradition in LGBT culture. Drag has been regarded as an area where transgender people can find more acceptance and financial support than mainstream work environments. Generally the terms drag queen covers men doing female drag, drag king covers women doing male drag, and faux queen covers women doing female drag.

Genderqueer

Genderqueer is a recent attempt to signify gendered experiences that do not fit into binary concepts, and refers to a combination of gender identities and sexual orientations. One example could be a person whose gendered presentation is sometimes perceived as male, sometimes female, but whose gender identity is female, gendered expression is butch, and sexual orientation is lesbian. It suggests nonconformity or mixing of gendered stereotypes, conjoining both gender and gayness, and challenges existing constructions and identities. Genderqueerness is unintelligible and abjected in the binary sex/gender system.

People who live cross-gender

People who live cross-gender live always or mostly as the gender other than that assigned at birth. If they want to be or identify as their gender assigned at birth, then the term "crossdresser" may be used. If they want to be or identify as the gender they always or mostly live in, then the term "transsexual" may be used. The term "transgender" or "transgenderist" has been applied to people who live cross-gender without sex reassignment surgery.

Androgyne

An androgyne is a person who does not fit cleanly into the typical gender roles of their society. Androgynes may identify as beyond gender, between genders, moving across genders, entirely genderless, or any or all of these. Androgyne identities include pangender, bigender, ambigender, non-gendered, agender, gender fluid or intergender. Androgyny can be either physical or psychological; it does not depend on birth sex and is not limited to intersex people. Occasionally, people who do not define themselves as androgynes adapt their physical appearance to look androgynous. This outward androgyny has been used in fashion, and the milder forms of it (women wearing men's pants or men wearing two earrings, for example) are not seen as transgender behavior.

The term androgyne is also sometimes used as a medical synonym for an intersex individual.

Transgender in contrast with sexual orientation and transsexuality

Transgender vs. Sexual Orientation

Gender identity and transgender identity are fundamentally different concepts to that of sexual orientation. Transgender people have more or less the same variety of sexual orientations as cisgender people. In the past, the terms homosexual and heterosexual were used for transgender folks based on their birth sex. Professional literature now uses terms such as attracted to men (androsexual), attracted to women (gynosexual), attracted to both or attracted to neither to describe a person's sexual orientation without reference to their gender identity. Therapists are coming to understand the necessity of choosing terms with respect to their clients' gender identities and preferences.

Despite this distinction, throughout history the gay, lesbian, and bisexual subculture was often the only place where gender-variant people were socially accepted in the gender role they felt they belonged to; especially during the time when legal or medical transitioning was almost impossible. This acceptance has had a complex history - like the wider world, the gay community in Western societies did not generally distinguish between sex and gender identity until the 1970s, and generally perceived gender variant people more as homosexuals who behaved in a gender-variant way than as gender-variant people in their own right.

In the years following the sexual revolution of the 1960s, transgender sexuality has often been accepted into the fold of the burgeoning LGBT movement. The nature and degree of this acceptance has not been without controversy, however, and has drawn criticism from LGB and transgender people alike.

Transgender Vs. Transsexual

The word transsexual unlike the word transgender has a precise medical definition.
It was defined by Harry Benjamin in his seminal book "The Transsexual Phenomenon".
In particular he defined transsexuals on a scale called the "Benjamin Scale". Which defines a few different
levels of intensity of transsexualism. Listed as "Transsexual (Nonsurgical)",
"True Transsexual (moderate intensity)", and "True Transsexual (high intensity)". Many transsexuals believe that
to be a true transsexual one needs to have a desire for surgery.

However it is notable that Benjamin's moderate intensity "true transsexual" needs estrogen medication as a "substitute for or preliminary to

operation." There also exist people who have had SRS but who do not meet the definition of a transsexual such as Gregory Hemmingway. While other people do not desire SRS yet they clearly meet Dr. Benjamin's definition of a "true transsexual". Beyond Dr. Benjamin's work which focused on Male to Female transsexuals there is the case of the Female to male transsexual for whom surgery is not practical.

Outside of the above medical definition there are a wide range of gender expressions which are contrary to the

Some transsexuals also take issue with the term because Charles "Virginia" Prince, the founder of the cross dressing organization Tri-Ess and coiner of the term "transgender", did so because she wished to distinguish herself from transsexual people. In "Men Who Choose to Be Women" Prince wrote "I, at least, know the difference between sex and gender and have simply elected to change the latter and not the former". There is a substantial academic literature on the difference between sex and gender, but it is possibly worth noting that pragmatic English this academic distinction is ignored and "gender" is used mostly to describe the categorical male/female difference while "sex" is used mostly to describe the physical act.

There is political tensoion between the identities that fall under the "transgender umbrella. For example, transsexual men and women who can pay for medical treatments (or who have institutional coverage for their treatment) are likely to be concerned with medical privacy and establishing a durable legal status as men and women later in life. Extending insurance coverage for medical care is a coherent issue in the intersection of transsexuality and economic class. Most of these issues can appeal even to conservatives if framed in terms of an unusual sort of "maintenance" of traditional notions of gender for rare people who feel the need for medical treatments. Some trans people might express this by saying "I don't challenge the gender binary, I just started out on the wrong side of it.

Transgender and healthcare

Mental healthcare

Beginning therapy is recommended for all people who are frustrated by their gender, especially if they desire to transition. People who experience discord between their gender and the expectations of others or whose gender identity conflicts with their body benefit by talking through their feelings in depth with someone who will listen indefinitely. However, gender identity is new to psychology and research is still in its infancy.

Transgender people may be eligible for diagnosis of gender identity disorder (GID) "only if [being transgender] causes distress or disability. This distress is referred to as gender dysphoria and may manifest as depression or inability to work and form healthy relationships with others. This diagnosis is often over-simplified to mean that simply being transgender means a person suffers from GID which is not true. This has caused much confusion to transgender people and those who strongly seek to either criticize or affirm them. Transgender people who are comfortable with their gender, whose gender does not directly cause inner frustration or impair their functioning, do not have GID and are not applicable for a related mental disorder. Further, GID is not permanent and is usually resolved through therapy and transitioning, especially its social aspects. GID does not refer to people who feel oppressed by the negative attitudes and behaviors or others including legal entities in the same way that racist institutions do not create a "race disorder." Neither does GID imply an opinion of immorality - the psychological establishment holds the position that people with any kind of mental or emotional problem should not receive stigma. The solution for GID is whatever will alleviate suffering and restore functionality; this often, but not always, consists of undergoing a gender transition.

Transgender issues are both new in the scientific field and affect relatively few people, so understandably many mental healthcare providers know little about transgender issues. People seeking help from these professionals often end up educating the professional rather than receiving help. Among those therapists who profess to know about transgender issues, many believe that transitioning from one sex to another the standard transsexual model is the best or only solution. This usually works well for those who are transsexual, but is not the solution for other transgender people, particularly genderqueer people who do not identify as exclusively male or female.

Transgender and the law

Legal procedures exist in some jurisdictions allowing an individual to change their legal gender, or their name, to reflect their gender identity. Requirements for these procedures vary from an explicit formal diagnosis of transsexualism, to a diagnosis of gender identity disorder, to a letter from a physician attesting to the individual's gender transition, or the fact that one has established a different gender role.

Among the ancient Middle Eastern Akkadian people, a salzikrum was a person who appeared biologically female but had distinct male traits. Salzikrum is a compound word meaning male daughter. According to the Code of Hammurabi, salzikrūm had inheritance rights like that of priestesses; they inherited from their fathers, unlike regular daughters. A salzikrum's father could also stipulate that she inherit a certain amount.

Criticism

Transgender issues are controversial in both the public and scientific spheres. Critics believe that trans people are unhealthy varying from an innocent confusion to a mental disorder to an immoral perversion. They believe that trans people who embrace their feelings by transitioning either socially, surgically, or both are especially harmful to themselves emotionally and physically. Trans-affirming people may call these criticisms "transphobia" or "trans-bashing", considering them personal attacks based on hatred and/or fear.

Gender tied to sex

The conservative view is that sex determines gender, and that there is no practical difference between the two. In this view, genitalia or "birth sex" or chromosomes or something (positions vary) deeply and permanently determines one's essential identity as a woman or man. Trying to violate this divide is both impossible, unnatural, and unhealthy. It is often pointed out that chromosomes are immutable and that a male will always look like a male, not a female, even after sex reassignment surgery and hormones. Surgery and hormone therapy have medical risks which typically include infertility. While trans people may claim to feel like a certain gender, only a biological female can genuinely feel what it is to occupy a woman's body, including having experiences such as childbirth.

In the words of Jerry Leach (who formerly identified as a transvestite then very briefly as a transsexual and now is the director of Reality Resources):

"Rather than cutting tissue by invasive surgery and starting a new life, which for the most part doesn't work, people need to find help psychiatrically."

These arguments are examples of biological determinism. They do not generally address people who are infertile, or both intersex and trans identifying, or passing transsexuals (all of whom actually exist).

Religious criticism

While religions have a variety of attitudes about transgender people, the traditions of Abrahamic religions look upon crossdressing as wrong.. They see the Adam and Eve narrative as showcasing that God created the pattern of humanity as only female and only male.

As driven by libido

The controversial Blanchard, Bailey, and Lawrence theory characterizes transwomen as having one or another sexual motivations for transition. For example, Anne Lawrence, an openly autogynephilic transsexual , has hypothesized that the desire by persons with autogynephilia, including some cross dressers and some transsexuals, to alter their body can be compared with apotemnophilia (alternately body integrity identity disorder if framed as an identity issue rather than a fetish). Characterizations related to libido like these have been criticized by many in the medical and transgender communities alike as being potentially unscientific and transphobic.

The issues around psychological classifications and associated stigma (whether based in paraphilia or not) of cross dressers, transsexual men and women (and for that matter lesbian and gay children who may be difficult to tell apart from trans children early in life) have recently become more complex since it was announced that CAMH colleagues Kenneth Zucker and Ray Blanchard would serve of the DSM-V's Sexual and Gender Identity Disorders Work Group Within the trans community this has mostly produced shock and outrage, including a petition against the appointments and attempts to organize other responses